The Cleveland Browns are involved in a controversy. I should also report that the sky is blue, the grass is green, and water is wet. This time, the Browns have come under fire for how they treated Colt McCoy after he got hit by James Harrison in the fourth quarter of the football game this past Thursday night. I was just as shocked as the rest of my colleagues were when Colt reentered the game. His return is being reported as occurring just 3 minutes and 50 seconds of real time (not game time) after getting hit. Local radio talk show hosts are using the incident to further their cause for ousting Pat Shurmur as the head coach and people calling in are agreeing with them. Colt's father even discussed with a local journalist and called the Browns' actions egregious and that his son should not have returned to play. Needless to say, it has caused quite a lot of conversation locally, and a fair amount nationally.
To nobody's surprise, fans' amazing powers of prediction were confirmed when the Browns released the injury report and Colt was listed as suffering "concussion like symptoms." According to reports, the symptoms started after the game was over. This is not out of the realm of possibility and symptoms may not have appeared until after the game ended since it was the fourth quarter when the hit occurred. I have seen many instances where it takes 10, 15, or even 20 minutes before any symptoms appear that would indicate the athlete's cognitive function has been compromised. A bigger issue arises in the fact that Colt was only on the sidelines for less than four minutes. There is no way to perform a comprehensive evaluation of a person's cognitive functions in that short amount of time. Simply getting symptom score from the SCAT2 would be difficult in that short time given the amount of noise that was present around the evaluator and Colt in Heinz Field. To complicate matters, Colt did complain of some pain in his thumb that the ATCs would also need to examine in that short time and Colt was lying on the field for some time after the hit while the broadcast cut to a commercial.
Granted, there were only a few people on the sideline that would know what the story is and how it unfolded, but it does seem to me that after a particularly hard hit like that, it would behoove the medical staff to at least get a concussion exam performed. It does seem highly likely that a TBI screening was never performed on the sideline before allowing Colt to reenter the game, which would confirm Mr. Mortensen's assertions on Sunday that the Browns lied about the TBI evaluation and allowed him to return to play. The critics' arguments are based on the fact that Colt "was suffering from concussion like symptoms" at the time of the hit because he was "obviously knocked out when the hit occurred." I would love to know what kind of visual aid these critics were using to diagnose this because I cannot possibly confirm or disprove that Colt was indeed, "out cold." The only person that might know that would have been James Harrison, if he bothered to look at Colt after the hit. Unfortunately, the replays cut away too quickly to know if Mr. Harrison had looked. I have seen a lot of athletes simply lie on the ground for a half second after a hit to "catch their breath" before getting up and running off. This "knocked out cold" diagnosis is impossible to make from the camera angles, the existence if the helmet, and distance. Therefore, we must rely upon what the medical staff saw at the time of the hit. Since I wasn't there, I cannot offer an opinion and I believe that nobody else should either, especially non-medically trained radio talk show hosts and callers.
Since the medical staff will not be speaking to the press anytime soon (the federal law, HIPAA, makes it highly improbable that it will ever happen), we have to rely on the official information being released by the Browns. This information has been tightly controlled and therefore, leads to a lot of speculation. The problem is that the media needs to realize that they won't always be given all the answers to report and their speculations are not the truth. This often leads to other issues that make every athletic trainer's job significantly more difficult. The issue that faces the high school and collegiate AT is that leaves athletes and parents wondering about what the proper protocol is when their son or daughter gets hit in the head. Why do I take so much longer to evaluate a kid when the Browns can do it in under 4 minutes? It makes me look like a poor professional and it leaves the high school and collegiate ATs in a pinch when this situation comes up. It then takes an extraordinary amount of time to explain the difference that I can only hope takes place after I have completed my thorough examination, not during it.
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